Provider Demographics
NPI:1487874442
Name:SWINER, CARMELITA NICOLE (MD)
Entity type:Individual
Prefix:DR
First Name:CARMELITA
Middle Name:NICOLE
Last Name:SWINER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2400 BROAD STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27704
Mailing Address - Country:US
Mailing Address - Phone:919-220-9800
Mailing Address - Fax:919-220-9500
Practice Address - Street 1:2400 BROAD ST
Practice Address - Street 2:SUITE 1
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27704-2661
Practice Address - Country:US
Practice Address - Phone:919-220-9800
Practice Address - Fax:919-220-9500
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC2006-01809207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC5907012Medicaid
NC14592OtherBCBS
NC5907012Medicaid